Intraoperative Colonoscopy in Laparoscopic Assisted Colorectal Sugery for the Assessment of Anastomosis With Double Stapling Technique

Chu Matsuda, Hiroshi Tamagawa, Kazuhiro Iwase, Kazuhiro Nishikawa, Takashi Deguchi, Junji Kawata, Yasuhiro Tanaka, Osamu Nishiyama, Takanobu Irie. Osaka General Medical Center


• Introduction: The aim of our study was to evaluate the use of intraoperative colonoscopy in laparoscopic assisted left-sided colorectal resection for the assessment of anastomosis.
• Methods and Procedures: All consecutive laparoscopic assisted left-sided colorectal resections performed at our department between October 2008 and September 2011 were included in this study. After colorectal resection and reanastomosis with double stapling technique, an intraoperative colonoscopy was performed to detect anastomosis risk.
• Results: A total of 130 patients were enrolled in this study, and the anastomosis was checked via colonoscopy. Of the 130 patients, 50 (38.5%) underwent a laparoscopic assisted sigmoid resection, 37 (28.5%) a laparoscopic assisted high anterior resection, 43 (33.0%) a laparoscopic assisted low anterior resection. In this study, 2 (1.5%) anastomostic bleeding were detected and endoscopic clipping was performed during surgery. A total of 3 (2.3%) postoperative anastomostic bleeding occurred, but did not required hemostasis. 2(1.5%) anastomostic leakages were detected and oversewn. A total of 6 (4.6%) anastomostic leakage occurred in the early postoperative period.
• Conclusions: Intraoperative air leak test using colonoscopy might not predict the possible postoperative anastomotic leakage; however, it is useful for the detection of the unexpectable failure around anastomotic site. The complication rate of anastomosis in laparoscopic-assisted colon resection can be reduced by intraoperative colonoscopy.

Session Number: Poster – Poster Presentations
Program Number: P072
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